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In desperate need of help!!!

OK, so I have DS who will be 5 weeks old (3 weeks old gestational age) tomorrow. I have be EP'ing and last week started to work on getting him to the breast. Unfortunately we have had a set back! He was admitted to the hospital last tuesday with RSV and slow weight gain. I was told by the peds that they wanted to have LC do a calorie count on my breast milk to see if that was the reason for his slow weight gain. When the hospital's LC came to see me she said that she did not think it was an issue with calories, that it was an issue with supply. She also told me not to try and breast feed while he was in the hospital since he was having such a hard time breathing. She told me to pump every two hours to build up my supply. I have been doing this for 4 days so far and I'm not seeing any significant results. I was told by another LC a couple weeks ago that my nipples were kinda flat and gave me a nipple shield to use and an SNS. We came home from the hospital yesterday and I have been offering him the breast before every feeding and sometimes he will latch on (not properly) with the nipple shield and not latch on at all without it. When I try to put him on my bare nipple, he will open and try to latch, will suck a couple times and then pull his head back and wiggling everywhere in frustration. Since I have been pumping almost every 2 hours, my nipples and areola are so sore and red. After I get finished pumping I will try to hand express but the tissue under my areola is so sore and swollen and I dont know if thats from pumping or if I have clogged ducts under my areola. I was planning on going to a LLL meeting this past thursday, but where he has RSV, I didn't want to expose him to other babies!!!! After I offer him the breast and he gets frustrated, I will end up giving him a bottle and the only nipple he will eat from are the red rubber latex nipples that you get from the hospital which are supposed to be a one time only use with the pre mix formula bottles. I bought a medela calma nipple and he will suck, suck and suck and not get anything from it!

Re: In desperate need of help!!!

Wow, tons going in. So, lets approach it systematically. 1) Keeping up your supply- Nipples sore and in pain-from pumping? Not good. What kind of a pump are you using? If baby cannot nurse it should be a hospital grade (rental) if possible. Check the size of the flanges and make sure you have a proper fit. Your nipple should be moving easily/freely in and out of the tunnel when you pump. If it's rubbing, you can use a thin layer of olive oil as a lube on the flange but that is just a temp fix you need proper size flange. Too large flange can cause damage too, if too much of your areola is being pulled into the tunnel and too large can cause poor output too. Start pumping on the lowest setting possible and dial up but make sure it stays comfortable. If baby is not nursing at all it is good to aim for 10 pumping sessions in a 24 hour day. Have you been able to do that? If pumping is causing too much damage/pain and baby still cannot latch, try to hand express. Also how LONG are you pumping for? Some moms pump too long. I think 15-20 minutes per side is the typical recommendation?????

2) Feed the baby-How is baby being fed now? Bottle, or some other way? What are you feeding baby? I know you likely do not want to do this but if you cannot pump enough and you cannot get donated breastmilk you may have to supplement with formula. It's OK, you gotta do what you gotta do.

3) Get hands on help: I know you saw the LC in the hospital and (thank goodness) she knew the issue was not low cal breastmilk which just does not happen. And you saw one earlier, or at least talked to her. But have you had any private, one on one, working sessions with a Board Certified Lactation Consultant (IBCLC?) These last a minimum of an hour, usually 90 minutes, and would involve the IBCLC looking at your breasts, possibly looking in babies mouth, taking a full history, watching you nurse (or attempt to nurse) and giving you ideas as you did so, maybe doing a before and after nursing weight check, and then giving you a follow-up plan and a chance to see/call for follow-up assistance. If appropriate she may teach you to use an at the breast supplementer, or a nipple shield, whatever. When a baby cannot latch or is not getting enough it is really important to not only see the right professional but also to spend the right amount of time with them. Latch issues take time to solve.

If someone else can take baby, you can attend a LLL meeting alone, for tips and support. Also just call your local Leader and talk to her. She can help you talk through your issues over the phone. A few will do home visits. Anything a Leader does for you will be free, But an LLL Leader is not a IBCLC.

It sounds like you are having some success with the nipple shield. These are a problematic tool, especially if low supply is already a concern, HOWEVER, if it is the only way a baby can latch and nurse, it is infinitely better (imo) to be using a shield so baby can nurse at the breast than to only have baby getting expressed milk. But you may need to keep pumping to make sure your supply is not affected by using the shield, and also monitor babies intake by looking at output and weight gain closely.

Re: In desperate need of help!!!

Of course you've already gotten wonderful advice but I'd also like to offer some hope and tell you not to ever think its too late. I EP'd for the first four months with my first DD because of nipple confusing. I was successful at getting her back on the breast at 4mo. and went on to nurse her until she was 33mo. It can be done! Sometimes it just takes longer for a baby to learn to latch than it does for other babies Hoping for the best for you! Hang in there!